<!--
  ========================LICENSE_START=================================
  screenit-web
  %%
  Copyright (C) 2012 - 2020 Facilitaire Samenwerking Bevolkingsonderzoek
  %%
  This program is free software: you can redistribute it and/or modify
  it under the terms of the GNU Affero General Public License as published by
  the Free Software Foundation, either version 3 of the License, or
  (at your option) any later version.
  
  This program is distributed in the hope that it will be useful,
  but WITHOUT ANY WARRANTY; without even the implied warranty of
  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  GNU General Public License for more details.
  
  You should have received a copy of the GNU Affero General Public License
  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  =========================LICENSE_END==================================
  -->
<html xmlns:wicket="http://wicket.apache.org">
<wicket:panel>
    <form wicket:id="locatieForm" class="not-tracked-for-changes-on-page">
        <div class="modal-header">
            <button type="button" class="close" wicket:id="close">&times;</button>
            <h3 wicket:id="titel">Locatie</h3>
        </div>
        <div class="modal-body">
            <div class="form-horizontal">
                <wicket:enclosure child="startDatum">
                    <div class="control-group">
                        <label class="control-label">Periode</label>
                        <div class="controls">
                            <div class="input-append">
                                <input wicket:id="startDatum" class="datum vanaf" type="text"
                                       value=""> <a href="javascript:void(0);" class="btn"
                                                    onclick="$(this).parent().find('.vanaf').datepicker('show');return false;"
                                                    title="Datum" tabindex="-1"><i class="icon-calendar"></i></a>
                            </div>
                            <i class="icon-asterisk icon-purple"></i>
                            t/m
                            <div class="input-append">
                                <input wicket:id="eindDatum" class="datum tot" type="text"
                                       value=""> <a href="javascript:void(0);" class="btn"
                                                    onclick="$(this).parent().find('.tot').datepicker('show');return false;"
                                                    title="Datum" tabindex="-1"><i class="icon-calendar"></i></a>
                            </div>
                            <i class="icon-asterisk icon-purple"></i>
                        </div>
                    </div>
                </wicket:enclosure>

                <div class="control-group">
                    <label class="control-label">Straat/Nummer/Toevoeging</label>
                    <div class="controls">
                        <input wicket:id="straat" class="input-large" type="text" value=""> /
                        <input wicket:id="huisnummer" class="input-small" type="text" value="">/
                        <input wicket:id="huisnummerToevoeging" class="input-small" type="text" value="">
                    </div>
                </div>
                <div class="control-group">
                    <label class="control-label">Postcode/Plaats</label>
                    <div class="controls">
                        <input wicket:id="postcode" class="input-mini" type="text" value=""> /
                        <input wicket:id="plaats" class="input-large" type="text" value="">
                    </div>
                </div>
                <div class="control-group">
                    <label class="control-label">Locatiebeschrijving</label>
                    <div class="controls">
                        <textarea style="width: 95%; resize: none;" wicket:id="locatieBeschrijving"></textarea>
                    </div>
                </div>
                <div class="control-group">
                    <label class="control-label">Bijlage</label>
                    <div class="controls">
                        <div wicket:id="upload"></div>
                    </div>
                </div>

                <div class="control-group">
                    <label class="control-label">Brieven apart printen</label>
                    <div class="controls">
                        <input type="checkbox" id="brievenApartPrinten"
                               wicket:id="brievenApartPrinten"/>
                    </div>
                </div>
                <div class="control-group">
                    <label class="control-label">Huisnummer tonen in uitnodigingsbrieven</label>
                    <div class="controls">
                        <input type="checkbox" id="toonHuisnummerInBrieven"
                               wicket:id="toonHuisnummerInBrieven"/>
                    </div>
                </div>
            </div>
        </div>
        <div class="modal-footer">
            <button class="btn btn-primary right" wicket:id="opslaan">Opslaan</button>
        </div>
    </form>
</wicket:panel>
</html>
